Storms Ambulance Fact Finding Committee – Final ReportSubmitted by: Matthew DeBarbieri May 4, 2007

Objective The Administration’s objective in forming this fact-finding Committee was to enable the city to define the relationship between the City of Derby and Storms. Understanding that they are Incorporated but receive city funds, we wanted to separate the facts from the various conflicting opinions and innuendo concerning their autonomy within that relationship. It was our objective to attempt to see if any corrections or new procedures needed to be implemented to ensure cost and operational efficiency. In the course of our research, Chief Lenart was invaluable in providing the requested tax returns and financial information in a timely manner. We also asked Mr. Lenart a battery of questions about his methods of operation. All questions were answered to our satisfaction and are attached to this report below.

Analysis In this committee’s opinion, Storms Ambulance Corps runs an organized, highly effective unit. We all agree that their level of service is second to none. We feel that the fees the city pays them are justified and the quality of equipment and services we receive is far above what the city would be able to provide were they to take over management of the corps. Surrounding towns have also long benefited from the high service standards of Storms Ambulance. We see no reason to alter the nature and terms of that relationship. We commend Mr. Lenart and his entire unit for their years of dedication and thank him for his patience in answering questions that have surfaced over the last few years. Storms Ambulance is an asset to Derby and the State of Connecticut and we look forward to being their home base for years to come.

Recommendations This committee feels that the Ambulance Corps, in it’s current state, runs a highly effective unit and we see no need to recommend any changes to their current operations. We applaud and are confident that Storms will continue to find creative, efficient alternatives to funding, as they have in the past. As we are all aware, the City of Derby is trying to improve itself upon several fronts that have long been neglected. The city’s potential is limitless; however, its funds are not. We encourage Storms to bring creative alternatives to their

funding issues forward. For example, repairing or updating certain equipment instead of buying new, as long as it will not negatively impact the level of service that Storms provides. We feel confident in the understanding of fiscal constraints and know that the city and the ambulance corps will continue to act for the benefit of the other.

Appendix - Questions from Committee; answered by Sgt. Lenart

1. What happens with the assets (City/Storms) cash buy out of assets?A: I am really not sure what happens to the assets, I can only give a suggestion and something that has been very briefly discussed by the members, and please do not hold me to this because our membership will have to vote and accept anything like this, but turning over the assets to the city is not out of the question if the city guarantees us up front that the assets will not be broken up (i.e. rescue to the FD, ambulance to EMS, haz-mat to PD etc.) and that when they need replacement they will be replaced with like kind and quality equipment. The other condition is that there is a guarantee that a City of Derby EMS service will continue to exist in its present form.

2. What is the effect on VEMS and primary response areas?A: There should be no effect on VEMS, however the city needs to really examine placing a paramedic on the ambulance, there are numerous reasons that this is a positive for the residents and the EMS services. Do not let the liability scare you; we are already an advanced life support service and as such carry the same medical malpractice insurance that a paramedic service carries. It is also not likely to cost much as we already have most of the equipment needed. The primary response area will not change.

3. What are the responsibilities and obligations for mutual aid? A: This is a very simple answer; we do not have any choice but to respond to a call for service. If the call is received through the 911 system and we are designated as the next or closest available resource, no matter where the call is in Connecticut we have no choice but to respond. That is the assurance the public has that a resource will respond to the public’s call for services when the system is overloaded as it sometimes gets. There can be no calls for three days

and then 5 all at the same time in another town we are mandated to assure that our resources are available.

4. Will (potential) employees be full-time employees? A: That issue will depend upon what is best for all parties concerned, at this time we are using part time employees to staff the ambulance 6AM-6PM and volunteers after those hours, there should be no change unless it is more cost effective to change. I will say that at this time the (officers) do not draw any stipend for their services and if the city does take the service the three line officers should get compensation as a minimum comparative to a fire chief. (No, I’m not looking for a job; I will continue to volunteer my services no matter what happens.)

5. Will they be pension eligible? A: Again we are looking at part time employees I don’t think they will be pension eligible employees

6. Who would do the hiring of the staff (EMT’s)?A: I believe the officers of the ambulance corps are most qualified to hire, however it will be according to City of Derby hiring practices

7. What about Paramedic liability insurance?A: We already pay for medical malpractice, it is a state law that an ambulance service must carry this coverage to the level of its certification to be certified by the department of health, there should be no appreciable change in cost.

8. Who would the department report to in the organizational chart? A: The state of Connecticut, through the home rule statutes, gives the responsibility for delivering EMS to the Chief elected official of the city or town. In 1948, the city of Derby worked out the agreement to provide EMS between the Board of Aldermen and the Storm Ambulance Corps. Therefore, a City Department of Emergency Medical Services should be independent and report directly to the Board of Aldermen.

9. What is the cost/benefit analysis?A: While not having done a formal cost analysis because there are no defined parameters, I can only make an educated guess, and that would be that for the most part. It should be no more costly for either entity to keep the service the way it is now or for the city to take the service as a city department. I do believe that a city department will benefit the city in grants and funding. Administratively for the ambulance service, a person designated by the City as the Chief of its EMS is directly responsible to the city for operations of EMS. If the City wants to pay for a cost analysis let it begin.

10. Will housing become fair game?A: By this I am assuming rent for space. I will tell you that we use as our office a building built for the City of Derby with federal funds specifically for the purpose of housing the Storm Ambulance, we maintain the building and pay utilities on all services to the building however it is owned by the City of Derby. We share two other spaces, the middle bay at the Storm Engine Company which houses the rescue truck and the ranger vehicle, and for the last year a bay at the East End Hose Company for ambulance coverage on the east side of Derby. While these spaces are in the city firehouses, the vehicles are used exclusively for the services to the city of Derby residents, the spaces are common to the rest of the floors and are heated, lighted as part of the normal operations of the buildings so there is no additional cost for our vehicles to be in there, and we have paid for maintenance and up keep of doors and floor space in both buildings. Additionally all four fire companies in Derby do not pay for utilities, maintenance of the buildings so it seems unfair to make us do so, since we already pay for a lion share of what we use in the ambulance building.

11. What about the assets, (houses, funds, trust)? Who do they go to? A: This question perpetuates a rumor that has been around for many years and I again will state that to my knowledge there are no houses, funds or trusts out there. It has always been rumored that these things are there. Unless someone has them and is not telling us, there are none.

12. Must Competitive Solicitation for a private organization covering the district be performed? A: Storm Ambulance holds the Primary Service Area designation, the PSA is like an exclusive franchise. (Storms) hold that PSA designation until one of two things happens, we say we can no longer can honor the commitments of providing

service, at which time we can transfer it to our designee, or we are proven to be improperly covering our PSA at which time the state will come in and designate a service to provide services until it can open it up for competitive bids. PSAs are designated and awarded by the DPH to avoid the removal of emergency medical services for political or other reasons which has happened in the past. The only way to go to a competitive bidding process is when there is no one capable of providing services to a Primary Service Area or those designated to do so cannot provide the services necessary. If a competitive bidding process would be able to be performed it would need to include technical rescue 24/7, Haz-Mat 24/7, water rescue 24/7 and 2 ambulances available with crews 24/7 and community educational services. An informal solicitation was done a few years ago and it was found that it would cost the city almost 4 times as much as the city was providing to us (at that time $80,000.00 municipal grant and insurance and fuel) for just one ambulance staffed 24/7 to be available to the city.

13. Where are the operating expenses and revenue sources for collections?A: Reports have been provided to the Mayor’s office on an annual basis, along with our federal tax returns. Also separate reports broken out of the main report on cost of paid staff and collections from billing revenue were included in the annual report to the Board of Aldermen this year. The federal tax return is not to be completed until June, as we, a non-profit organization, are not required to file until then.

14. What about the recent agreement that was signed?A: That was not an agreement with Storm Ambulance Corps. That was the City of Derby’s Emergency Medical Services Plan which was mandated by the State of Connecticut. All municipalities in Connecticut were required to have on file, by June of 2003, a comprehensive Emergency Medical Services delivery plan. It took four years to get the one for Derby signed. We had a large hand in writing the plan because EMS has been designated to Storm Ambulance and we operate the EMS system for the City.

15. Does the city‘s $80,000 contribution buy the right for financials or an audit?A: Financials are provided; I have given them to you and to the Mayor’s office. We had an audit done in 2005; a copy was turned over to the Mayor’s (former) assistant, John DeBarbieri. Our federal tax returns are also sent to the Mayor’s office. We also had a line by line review with you personally in August of last year. A non-profit business audit costs between $7,000.00 and

$9,000.00 if the city of Derby wants to spend that to get the same information I am supplying to it now. Add that to our municipal grant and I will have it done. Also, it takes a significant amount of time to meet with the auditors and deliver all of the information necessary. It would need to be discussed who is paying for the time it takes to accomplish this. On that note, I took it upon myself to speak with several towns of comparable size about their EMS costs and audits after receiving a report from the Connecticut Conference of Municipalities, the report was done in June of 2006. Here are my findings based upon 2005 numbers as 2006 were not available yet:

Orange, CT; population 13,587: The cost of just a dedicated paramedic with 24/7 availability is $198,831. Patient transports are given to American Medical Response as a courtesy for providing just paramedic service at a discount. No reporting on costs, just straight billing by AMR both to the patients and to the town.

Oxford, CT; population 11,112: Oxford Ambulance Service; $177,978 of town money, also billing for all patient transports. Audit paid for by town on annual basis in addition to ambulance funding. (Ambulance Service Only)

Ellington Volunteer Ambulance; population 14,141: $152,162 town money. Purchases reported to town on annual basis. Ambulance service only. Billing for transports.

Windsor Locks Ambulance Association Population; population 12,333: $137,000 town money. Annual reports supplied to town (ambulance service only) and billing for transports.

North Branford Ambulance Association; population 14,292: $115,000 is given to ambulance service. Annual financial report submitted to town (patient billing for transports).

As you can see, the municipal grant given to Storm Ambulance is not only on the low end of the scale, it is unusual for an audit to be required. Additionally, there are many other services provided by Storm Ambulance besides Emergency Medical Services. (Also provided are) technical rescue, Haz-Mat responses, water rescue, and community education (CPR, child safety, and first aid).